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自体游离硬颚黏膜重建眼睑的效果观察

     

摘要

BACKGROUND:Autologous hard palate mucosa has been validated to be a substitute of the tarsal conjunctival. OBJECTIVE:To investigate the treatment outcomes of autologous hard palate mucosa applied in the eyelid reconstruction. METHODS:180 patients (180 eyes) with eyelid defects aged 10-63 years old were recruited, including 122 males and 58 females, and subjected to the transplantation of autologous hard palate mucosa. In the same time, flaps were designed and transferred into the defected eyelid soft tissues. All patients were followed up for over 3 months to observe the treatment outcomes. RESULTS AND CONCLUSION:Three months after surgery, viscous secretions were found in the implanted region and conjunctival sac, which were relieved and eliminated by usage of antibiotic drops. All implanted hard palate mucosa survived within 1 year, neither infections nor falling off occurred, and blood vessels growth into the implant-tissue conjugation that inosculated with the host vessels presenting no rejection. The implants revealed different degrees of shrink in 132 patients, but the eye function was normal. During the hospitalization, some uncomfortable feeling such as eye pain had been relieved, and the wound showed no infections and healed well. During the follow-up, there were eight patients with slight lower eyelid ectropion and three with hypophasis. The length or height difference of both eyelids was within 2 mm, except those who lost eye bal s. These results suggest that autologous hard palate mucosa achieve satisfactory outcomes in the eyelid reconstruction and possesses good histocompatibility.%背景:临床显示自体硬腭黏膜对睑板结膜有较好的替代作用.目的:分析自体游离硬颚黏膜用于眼睑重建的临床效果.方法:纳入180例(180眼)眼睑缺损患者,其中男122例,女58例,年龄10-68岁,均进行自体硬颚黏膜移植修复治疗,眼睑软组织缺损部位采用皮瓣进行修复,治疗后随访观察患者情况及硬腭黏膜情况.结果与结论:所有患者均随访6个月以上.①治疗后3个月内,患者硬腭黏膜移植区及结膜囊内产生黏性分泌物,在使用抗生素滴眼液后得到减轻或消失;②硬腭黏膜移植片在随访的1年内全部存活,未发生感染或脱落情况,移植片与接受区域之间已有血管长入并局部已与原有组织血管吻合,未发生排斥反应;③132例患者自体硬腭黏膜移植片发生不同程度收缩,但眼部正常功能未受到影响;④住院期间眼部疼痛等不适症状已有明显减轻,创面未见感染或愈合不良的情况发生;⑤随访期间,8例发生轻度下睑外翻,3例轻度眼睑闭合不全,其余患者眼睑闭合情况及眼睑开闭功能均未见明显异常;⑥除了8例眼球缺失患者,其余患者双眼眼睑的长度差及高度差均在2 mm内;⑦结果表明,自体硬腭黏膜重建眼睑效果良好,具有较好的相容性.

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